The increase in autism spectrum disorder diagnoses means more members of our community identify as neurodiverse. Dr. Carla Wall, a psychologist on our developmental pediatrics team answers these 5 questions about how the uptick can lead to more widespread support and understanding for those with autism.
How is the stigma regarding neurodiversity changing and why do you think that is?
Neurodiversity is becoming increasingly common, with the prevalence of autism alone being 1 in 31. This means we have the privilege of having more parents and self-advocates who are outspoken about advocating for their needs and their perspectives. It is so important as clinicians and scientists that we to listen to the perspectives and lived experiences of those we serve. I’ve seen this change a lot in the language we use to talk about autism—from the shift from Autism Awareness Month to Autism Acceptance Month to discussions about the importance of person-first versus identity-first language.
What are some common misconceptions about people living with autism spectrum disorder and other types of neurological differences?
In the populations I serve, I consistently hear individuals and parents say that their questions about a diagnosis have been brushed aside by providers—the common misconception I hear is that the person "can't possibly have autism” because they don't fit into some stereotypical and misinformed box. This saying rings true: “if you've met one person with autism, you've met one person with autism.” We are learning so much more about how the disorder can manifest differently in girls and women, nonbinary individuals and people of color, and how we, as a field, have underserved these groups.
Why is it so important to be neurodiversity-affirming and disability-minded?
There are two different models of disability: the medical model and the social model. In this setting, I think most people tend to default to a medical model, which situates the disability within the individual. The social model of disability maintains that society and social structures are the source of the disability and seeks to accommodate the needs of the individual rather than "cure" them. As providers, I think this is critical because if we aren't accurately identifying the issue, we can't effectively treat it. This means shifting our perspective to how we can modify society to support the disability, rather than remove it. It’s nice because often the things that are accommodating to those with disabilities are also good for everyone. A good example would be that not everyone can access stairs, but all people can use a ramp. The same theory applies to those who are neurodivergent and those who are neurotypical.
Can you describe just how prevalent neurodivergent conditions are and the strengths related to those conditions?
Neurodevelopmental disorders, as they are defined in the Diagnostic and Statistical Manual of Mental Disorders, comprise a diverse set of diagnoses, from autism and ADHD, to learning disabilities like dyslexia, to intellectual disability, to other communication, motor and developmental delays. The current prevalence rates are 1 in 6 children in the U.S. have a diagnosed neurodevelopmental disorder, so they are extremely common. There are lots of strengths that can be associated with them, just as any other individual can have a diverse set of strengths, but some common ones I see are honesty, a strong sense of morality, innovative thinking, ability to focus and develop expertise in interesting areas, creativity and resilience.
Have you seen improvements with schools and employers making accommodations for neurodiversity?
Some companies have started to create employment training opportunities, and some universities have designated programs or supports for those who are neurodiverse, but I think we are far away from meeting the needs of individuals. In fact, I think supporting adults with neurodevelopmental disorders is one of the biggest areas in need of improvement. Because they are so frequently diagnosed in children, we associate these diagnoses with children and concentrate our support systems in pediatric departments and K-12 schools. But children grow into adults, and the adult healthcare system and employment/post-secondary education systems have not necessarily adjusted to the growing prevalence rates we see in pediatric populations.